IN-TIME trial confirms 50% reduction in mortality in HF patients


Experts discussed the benefits of Home Monitoring technology from the perspective of patients, hospitals and payers for the first time at a press conference held by BIOTRONIK at the European Society of Cardiology’s annual congress, ESC Congress 2014. Gerhard Hindricks, University of Leipzig Heart Center, Germany; Ignacio Fernandez Lozano, University Hospital Puerta de Hierro, Madrid, Spain; and Christophe Leclercq, Rennes University Hospital, France, all agree that Home Monitoring clearly improves patient health. This has been confirmed by comprehensive clinical trials involving more than 24,000 patients.

“After the European Society of Cardiology added a clear recommendation for the use of implant-based remote follow-up to its guidelines last year, now is the time for payers – health insurers and national health care systems – to acknowledge remote monitoring’s value for patients by reimbursing physicians follow-up and the technology itself,” explains Hindricks.

The IN-TIME trial, which was recently published in The Lancet, demonstrated that heart failure patients’ mortality can be reduced by more than 50% using Biotronik Home Monitoring. “These are excellent results that we would not have been able to obtain in the patient group by using drug therapy alone or another remote monitoring technology,” comments lead investigator, Hindricks. “We are making critical advances in patient therapy with implant-based telemedicine. Biotronik Home Monitoring quickly detects clinically relevant events, so we can adjust the therapy at the right time. This is crucial, especially when managing patients with heart failure whose condition changes quickly and often.”

The experts from the three countries confirmed that Home Monitoring is integral to their daily practice and they emphasised that remote follow-up does not create a higher workload since patients only come to the hospital when there is a medical need, rather than on a rigid calendar schedule. “At my hospital, we use Home Monitoring for all implantable defibrillator – ICD and CRT-D – patients. This allows us to detect events as they occur so I can spend time on patients that need my attention most,” emphasises Lozano.

“Patients’ wellbeing is our top priority,” adds Leclercq. “Remote monitoring is a treatment option that clearly improves patient health without incurring additional costs for hospitals or payers. It should be adopted, and physician follow-up and the Home Monitoring technology should be adequately reimbursed.”

Based on the French health care system, the ECOST trial demonstrated a cost reduction of over 300 euros per patient per year. Reimbursement for medical services performed during remote follow-up is now being discussed in France for the first time.

Remote follow-up is already reimbursed in Germany and the United Kingdom. Even in these countries, the EuroEco trial found no increase in costs for insurance providers or national health care systems. EuroEco, presented at ESC Congress 2014, identified a trend towards cost savings for payers with the use of Home Monitoring. This was caused by fewer hospital admissions and shorter lengths of stays, reinforcing previous findings about reductions in hospitalisations and strokes from trials including TRUST, COMPAS and ECOST.